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HANDOVER
FORM
91-IPM-RT-HO-RLC-
Project: NARA RESIDENCES BY ROCKWELL Reference 002C
Number March 17, 2021

Address: GM CORDOVA AVE., (BURI ROAD), BACOLOD CITY Date of

Handover

Scope 91-SI-RSD-008/008 or SI-RT-SSD-008

This is to formally hand-over the following items to the respective client as stated:

AR ITE QTY REMAR

EA MS KS
ROOM 7(ISOLATION ROOM) MAIN DOOR KEY 1 UNIT

ROOM 7(ISOLATION ROOM) ROOM 4 CR KEY 1 UNIT

ROOM 7(ISOLATION ROOM) PILLOWS 2 UNITS

ROOM 7(ISOLATION ROOM) MATTRESSES 2 UNITS

ADDITIONAL NOTES/REMARKS

ATTACHMENTS/REFERENCE DOCUMENTS
NO.
ITE PAPER DESCRIPTI REMARKS
OF
M SIZE ON
SHEET
S
9 HARD COPY
1 A4 SITE INSTRUCTION
SHEETS
2 1 SHEET A3 FLOOR PLAN HARD COPY
3 2 A4 ACCOMPLISHMENT PHOTOS HARD COPY
SHEETS

Printed Name, Signature and Date:

Handed-Over By: Accepted By:

Contractor Representative RLC Inspector/Coordinator

Noted By:
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Acknowledged By:
Contractor Project Manager

RLC Construction Manager

Project: NARA RESIDENCES BY ROCKWELL Reference Number: 91-IPM-RT-HO-RLC-002C

Address: GM CORDOVA AVE., (BURI ROAD), BACOLOD CITY Date of Handover: March 17, 2021

Scope 91-SI-RSD-008/008 or SI-RT-SSD-008

ACCOMPLISHMENT PHOTOS OF ROOM 7 (ISOLATION ROOM)

(AS PER ACTUAL, 2 PAX)
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Project: NARA RESIDENCES BY ROCKWELL Reference Number: 91-IPM-RT-HO-RLC-002C

Address: GM CORDOVA AVE., (BURI ROAD), BACOLOD CITY Date of Handover: March 17, 2021

Scope 91-SI-RSD-008/008 or SI-RT-SSD-008

ACCOMPLISHMENT PHOTOS OF ROOM 7 CR (ISOLATION ROOM)